Provider Demographics
NPI:1013966811
Name:BRIGHT, MARY ANNE (EDD, APRN, BC)
Entity Type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:EDD, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:SUNDERLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01375-9579
Mailing Address - Country:US
Mailing Address - Phone:413-219-8038
Mailing Address - Fax:413-665-3960
Practice Address - Street 1:415 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:MA
Practice Address - Zip Code:01375-9579
Practice Address - Country:US
Practice Address - Phone:413-219-8038
Practice Address - Fax:413-665-3960
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111963364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult